Professional Responsibility, Ethics, and Infection Control
Ethics, law, and safety
Ethical practice rests on autonomy, nonmaleficence, beneficence, justice, and veracity. Informed consent requires disclosure of risks, benefits, alternatives, and the consequences of declining care. Confidentiality is protected under HIPAA, which permits only the minimum necessary disclosure of protected health information. Mandated reporting obligations include suspected child and elder abuse and, in many states, communicable disease reporting.
Scope of practice and supervision levels (direct, indirect, general, collaborative) vary by jurisdiction; general and collaborative supervision typically require a prior dentist examination and may require a written protocol. Know your state's rules as a testable framework concept.
Infection control follows the CDC and OSHA bloodborne pathogens standard: a written exposure control plan, hepatitis B vaccination offered, PPE (gloves, mask, eye protection, gown), hand hygiene with soap and water when visibly soiled and alcohol-based rub otherwise, safe sharps handling, and no two-handed recapping. Critical items (contacting bone or blood) must be sterilized; semicritical items (contacting intact mucosa) require sterilization or high-level disinfection; noncritical surfaces require low-level disinfection. Spore testing is done weekly with a control, and steam sterilization runs at 121°C and 15–30 psi for 15–30 minutes or 132°C for about 4 minutes. Packs need internal and external chemical indicators. Dental unit waterlines must meet 500 CFU/mL or less. After an exposure: wash, report immediately, evaluate the source, and start post-exposure prophylaxis ideally within 2 hours.
Trap: applying the wrong level of reprocessing - a blood-contaminated mouth mirror is a critical item and must be sterilized, not merely disinfected.